Pilot study: a cluster randomised trial of the provision of alcohol handgel to postpartum mothers to prevent neonatal infective morbidity in the home
Lead Research Organisation:
University of Liverpool
Department Name: Institute of Translational Medicine
Abstract
The research question is "Is the provision of alcohol hand gel to pregnant women in rural Uganda a clinically and cost-effective way of preventing early infant infections?". To provide context to this question across the globe, there are an estimated 3 million neonatal deaths annually. In Uganda, with over 1.5 million live births annually, 142,000 newborn infants die every year before reaching their fifth year with 33% of these in the neonatal period. This places Uganda 153rd out of 163 countries in the global rank for frequency of neonatal deaths. Most newborn infections and deaths occur in the community, and are frequently unreported to the health sector. For example, preliminary findings from the Iganga/Mayuge Demographic Surveillance Site showed that 60% of all deaths occur outside a health facility setting and go unreported. African community studies suggest an infection rate of around 30%.
In terms of infection prevention hand washing with soap even when washed with unclean water results in a large reduction in hand contamination. A recent systematic review concluded that there was a lack quality evidence for the effect of clean birth and postnatal newborn care practices on neonatal mortality. However, the need for clean birth and postnatal care is widely accepted. A Delphi expert consensus process judged that clean birth practices at home with no skilled attendant could reduce neonatal sepsis deaths by 15% and tetanus deaths by 30%. The panel judged that postnatal newborn care practices could prevent 40% of neonatal sepsis deaths, but that more research is needed particularly on the content and quality of care during the early postnatal period.
A research priority-setting exercise by World Health Organisation (WHO) on the reduction of newborn infection deaths found that the top ranked question was 'what is the feasibility, effectiveness, and cost of different approaches to promote the home care practices especially hand washing of caregivers?' Despite this being 4 years ago, there are no registered studies addressing the use of alcohol hand gels for mothers in the neonatal period, and local experts know of no similar study. The importance of hand-washing in preventing infective deaths has led WHO to develop guidelines for hand hygiene both within health care settings and in the community and integrate hand hygiene into neonatal community care programmes. For hand hygiene, the current recommended practice at the household level is handwashing with soap. However, studies show widespread non-adherence to the household guidelines, often due to a lack of water. An alternative option could therefore be alcohol based hand gel. This is cheap ($0.6 for 60mls) and active against a broad range of Gram-positive and Gram-negative aerobic bacteria, including staphylococci, streptococci, and enteric Gram-negative bacteria. Although alcohol-based hand rubs effectively prevent acute diarrhoeal diseases.
In terms of infection prevention hand washing with soap even when washed with unclean water results in a large reduction in hand contamination. A recent systematic review concluded that there was a lack quality evidence for the effect of clean birth and postnatal newborn care practices on neonatal mortality. However, the need for clean birth and postnatal care is widely accepted. A Delphi expert consensus process judged that clean birth practices at home with no skilled attendant could reduce neonatal sepsis deaths by 15% and tetanus deaths by 30%. The panel judged that postnatal newborn care practices could prevent 40% of neonatal sepsis deaths, but that more research is needed particularly on the content and quality of care during the early postnatal period.
A research priority-setting exercise by World Health Organisation (WHO) on the reduction of newborn infection deaths found that the top ranked question was 'what is the feasibility, effectiveness, and cost of different approaches to promote the home care practices especially hand washing of caregivers?' Despite this being 4 years ago, there are no registered studies addressing the use of alcohol hand gels for mothers in the neonatal period, and local experts know of no similar study. The importance of hand-washing in preventing infective deaths has led WHO to develop guidelines for hand hygiene both within health care settings and in the community and integrate hand hygiene into neonatal community care programmes. For hand hygiene, the current recommended practice at the household level is handwashing with soap. However, studies show widespread non-adherence to the household guidelines, often due to a lack of water. An alternative option could therefore be alcohol based hand gel. This is cheap ($0.6 for 60mls) and active against a broad range of Gram-positive and Gram-negative aerobic bacteria, including staphylococci, streptococci, and enteric Gram-negative bacteria. Although alcohol-based hand rubs effectively prevent acute diarrhoeal diseases.
Technical Summary
A pilot of the full study will be conducted in 10 villages around Busiu Health Centre IV and Lwangoli Health Centre III in the Mbale District of East Uganda. With an average of 3.5 deliveries per month in the study villages - a 3-month pilot will therefore include around 100 births.
Planned Impact
Impact Summary
Study objectives:
1. To determine the effectiveness of providing alcohol hand gel to pregnant women in rural Eastern Uganda as a way of reducing infant infective morbidity in the first 3 months of life
2. To determine the cost-effectiveness of providing alcohol hand gel to pregnant women in rural Eastern Uganda as a way of reducing early infant infections in the first 3 months of life
3. To prevent maternal infection in the first 3 months postnatally
This BabyGel clinical trial will have multiple beneficiaries. Policy-makers nationally and internationally, local government agencies and regulators and the commercial private sector are all likely to benefit from the clinical trial outcomes.
The Department of Women's and Children's Health in the University of Liverpool is a WHO Collaborating Centre and home of the Cochrane Pregnancy and Childbirth Group. Both these facilitate rapid integration of research findings into systematic reviews, as well as having long-established mechanisms for the dissemination of research findings. This will enable the findings to diffuse rapidly to international policy makers.
If the hand-gel is effective at reducing neonatal mortality then we envisage a range of strategies for scale-up including the placement of hand gel into maternal delivery packs, antenatal distribution, postnatal distribution through village health workers, or social marketing with the production of subsidised locally available gels.
Within Uganda itself, the research team includes members of key organisations who need to be aware of the research findings. These include: 1) experienced academic researchers in public health, maternal health and child health; 2) research training institutions (e.g. Makerere and Busitema Universities, Sanyu Africa Research Institute, Mbale Regional Referral Hospital) who will have new teaching and research tools to train researchers; 3) Government of Uganda Ministry of Health; and 3) over 7,000 research participants themselves, who will benefit from this simple self-help technique to improve maternal and neonatal health. The use of hand gel amongst participants will also spread the message directly to neighboring areas about the importance of hand hygiene, thus disseminating the hand hygiene message beyond the immediate study group. This trial will facilitate to reduce health inequity and help to develop sustainable communities throughout Mbale.
The impact summary comprises a range of initiatives aimed at:
1)Dissemination of information and outcomes at a range of levels
2)Research - capacity building
3)Local awareness raising of the importance of hand hygiene
4)Information sharing of individual components of the project
On-going Dissemination of Information and Outcomes
There will be significant opportunities for information sharing and policy transfer throughout the project. The project will be evaluated and the development of the project as a whole and will take place on an on-going basis.
Study objectives:
1. To determine the effectiveness of providing alcohol hand gel to pregnant women in rural Eastern Uganda as a way of reducing infant infective morbidity in the first 3 months of life
2. To determine the cost-effectiveness of providing alcohol hand gel to pregnant women in rural Eastern Uganda as a way of reducing early infant infections in the first 3 months of life
3. To prevent maternal infection in the first 3 months postnatally
This BabyGel clinical trial will have multiple beneficiaries. Policy-makers nationally and internationally, local government agencies and regulators and the commercial private sector are all likely to benefit from the clinical trial outcomes.
The Department of Women's and Children's Health in the University of Liverpool is a WHO Collaborating Centre and home of the Cochrane Pregnancy and Childbirth Group. Both these facilitate rapid integration of research findings into systematic reviews, as well as having long-established mechanisms for the dissemination of research findings. This will enable the findings to diffuse rapidly to international policy makers.
If the hand-gel is effective at reducing neonatal mortality then we envisage a range of strategies for scale-up including the placement of hand gel into maternal delivery packs, antenatal distribution, postnatal distribution through village health workers, or social marketing with the production of subsidised locally available gels.
Within Uganda itself, the research team includes members of key organisations who need to be aware of the research findings. These include: 1) experienced academic researchers in public health, maternal health and child health; 2) research training institutions (e.g. Makerere and Busitema Universities, Sanyu Africa Research Institute, Mbale Regional Referral Hospital) who will have new teaching and research tools to train researchers; 3) Government of Uganda Ministry of Health; and 3) over 7,000 research participants themselves, who will benefit from this simple self-help technique to improve maternal and neonatal health. The use of hand gel amongst participants will also spread the message directly to neighboring areas about the importance of hand hygiene, thus disseminating the hand hygiene message beyond the immediate study group. This trial will facilitate to reduce health inequity and help to develop sustainable communities throughout Mbale.
The impact summary comprises a range of initiatives aimed at:
1)Dissemination of information and outcomes at a range of levels
2)Research - capacity building
3)Local awareness raising of the importance of hand hygiene
4)Information sharing of individual components of the project
On-going Dissemination of Information and Outcomes
There will be significant opportunities for information sharing and policy transfer throughout the project. The project will be evaluated and the development of the project as a whole and will take place on an on-going basis.
Organisations
- University of Liverpool (Lead Research Organisation)
- World Health Organization (WHO) (Collaboration)
- Mbale Regional Hospital (Collaboration)
- University of Bergen (Collaboration)
- Liverpool School of Tropical Medicine (Collaboration)
- Sanyu Africa Research Institute (Collaboration)
- Makerere University College of Health Sciences (Collaboration)
- BUSITEMA UNIVERSITY (Collaboration)
- Ministry of Health, Uganda (Collaboration)
Publications
Burgoine K
(2015)
Antenatal corticosteroids for preterm births in resource-limited settings.
in Lancet (London, England)
Weeks A
(2016)
New WHO antenatal care model-quality worth paying for?
in Lancet (London, England)
Forshaw J
(2016)
Exploring the third delay: an audit evaluating obstetric triage at Mulago National Referral Hospital.
in BMC pregnancy and childbirth
Saito H
(2017)
Alcohol-based hand rub and incidence of healthcare associated infections in a rural regional referral and teaching hospital in Uganda ('WardGel' study)
in Antimicrobial Resistance & Infection Control
Ditai J
(2018)
Patients' roles in research: where is Africa?
in BMJ (Clinical research ed.)
Ditai J
(2019)
BabyGel pilot: a pilot cluster randomised trial of the provision of alcohol handgel to postpartum mothers to prevent neonatal and young infant infection-related morbidity in the community.
in Pilot and feasibility studies
Description | BACKGROUND: Alcohol-based hand rub (ABHR) is widely used in both health and social facilities to prevent infection, but it is not known whether supplying it for regular perinatal use can prevent newborn sepsis in African rural homes. Our study piloted a cluster randomised trial of providing ABHR to postpartum mothers to prevent neonatal infection-related morbidity in the communities. METHODS: We conducted a pilot parallel cluster randomised controlled trial across ten villages (clusters) in rural Eastern Uganda. Pregnant women of over 34 weeks' gestation were recruited over a period of 3 months. Both clusters received the standard of care of antenatal health education, Maama Kit, and clinic appointments. In addition, women in the intervention villages received ABHR, instructions on ABHR use, a poster on the 'three moments of hand hygiene', and training. We followed up each mother-baby pair for 3 months after birth and measured rates of consent, recruitment, and follow-up (our target rate was more than 80%). Other measures included ABHR use (the acceptable use was more than four times a day) and its mode of distribution (village health workers (VHWs) or pharmacy), acceptability of study protocol and electronic data capture, and the use of WHO Integrated Management of Childhood Illness (IMCI) tool to screen for newborn infection. RESULTS: We selected 36% (10/28) of villages for randomisation to either intervention or control. Over 12 weeks, 176 pregnant women were screened and 58.5% (103/176) were eligible. All, 100% (103/103), eligible women gave consent and were enrolled into the trial (55 intervention and 48 control). After birth, 94.5% (52/55) of mothers in the intervention and 100% (48/48) of mothers in the control villages were followed up within 72 h. Most, 90.9% (50/55), of the mothers in the intervention villages (96.2% of live births) and 95.8% (46/48) of mothers in the control villages (95.9% of live births) were followed up at 3 months. In intervention villages, the average hand rub use was 6.6 times per day. VHWs accounted for all ABHR stock, compared to the pharmacy that could not account for 5 l of ABHR. The screening tool was positive for infection among a third of babies, i.e. 29.2% (14/48) in the intervention villages versus 31.4% (16/51) in the control villages.VHWs completed the first four questions of IMCI screening tool with ease and accuracy. There were no adverse reactions with the ABHR. CONCLUSION: It is feasible to conduct a cluster-randomised controlled trial (cRCT) of the provision of ABHR to postpartum mothers to prevent neonatal infection-related morbidity in the community in resource-poor settings. Our results indicate that home recruitment promotes excellent follow-up and retention of participants in community trials. The intervention was safe. This pilot study informed the substantial changes necessary in the larger cRCT, including a change in the primary outcome to a composite outcome considering multiple methods of infection detection. A £5m EU grant from EDCPT has since been obtained to run the full BabyGel cluster randomised controlled trial - this opened to recruitment in 72 Ugandan villages in January 2021. |
Exploitation Route | The finding were used for an application for a large cluster RCT of the handrub intervention - this is now funded by EDCTP for Euro 5m and started recruiting in January 2021. |
Sectors | Healthcare |
URL | https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-019-0432-7 |
Description | This pilot study has led to a large EU funded grant through the European Developing Countries Trial Partnership (EDCTP). The £5m grant is held by the University of Liverpool but run through the Sanyu Africa Research Institute (SAfRI), the small NGO in Mbale, Uganda that was set up by Prof Weeks and James Ditai in 2012. This grant has hugely expanded the research capacity in Mbale, leading to collaborations between Busitema University (in Mbale), Mbale Regional Referral Hospital and Makerere University in Kampala. It has attracted some very talented research staff to work on the project, some of whom are now applying for their own research funding. We put in a collaborative grant for £500k to the Global Effort on COVID-19 (GECO) call which was to be sponsored and run by SAfRI in collaboration with the University of Liverpool. Sadly this was unsuccessful - but the application was very good and showed huge potential for the team there to apply for similar sized grants. |
First Year Of Impact | 2019 |
Sector | Healthcare |
Impact Types | Economic Policy & public services |
Description | WHO RP2 Research Assessment Panel |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Participation in a guidance/advisory committee |
Impact | The RP2 Panel is an invited group of 10 researchers in maternal and child health who assess all the WHO research projects in this area. They meet formally once a year in Geneva as well as reviewing research proposals via email. The projects all relate to research in low and middle income settings. |
Description | A cluster randomised trial to evaluate the effectiveness of household alcohol-based handrub for the prevention of sepsis, diarrhoea and pneumonia in Ugandan infants. |
Amount | € 5,977,299 (EUR) |
Funding ID | RIA2017MC-2029 |
Organisation | Sixth Framework Programme (FP6) |
Department | European and Developing Countries Clinical Trials Partnership |
Sector | Public |
Country | Netherlands |
Start | 02/2019 |
End | 02/2024 |
Description | Stars in Reproductive, Maternal, Newborn and Child Health |
Amount | $100,000 (CAD) |
Funding ID | R-ST-POC-1807-12800 |
Organisation | Government of Canada |
Department | Grand Challenges Canada |
Sector | Public |
Country | Canada |
Start | 03/2018 |
End | 10/2019 |
Description | Award of the WellBeing of Women / FIGO Fellowship to Professor Julius Wandabwa |
Organisation | Busitema University |
Country | Uganda |
Sector | Academic/University |
PI Contribution | We are mentoring Prof Wandabwa in evidence-based medicine: the conduct of systematic reviews and clinical trials. He visits the Sanyu Research Unit annually for training and joint preparation of a new Cochrane Review into Mechanical methods for the management of postpartum haemorrhage. |
Collaborator Contribution | Prof Wandabwa has visited Liverpool once so far for a training course into the preparation of systematic reviews. Prof Weeks has also visited him in Uganda for support and mentorship. Prof Wandabwa is an investigator for a number of ongoing studies in Mbale including BabyGel and studies of the PPH Butterfly (ongoing scoping work to develop a device for low income settings). |
Impact | None yet. |
Start Year | 2015 |
Description | Babygel Research Group |
Organisation | Busitema University |
Country | Uganda |
Sector | Academic/University |
PI Contribution | We are collaborating on an EDCTP grant together which follows on from the BabyGel MRC Pilot Study. |
Collaborator Contribution | We are all part of the trial management group, and lead various workpackages on the study. |
Impact | There have been multiple outputs from this group which arose from the MRC funded BabyGel pilot study. The full study is now commencing and will produce further outputs in due course. |
Start Year | 2012 |
Description | Babygel Research Group |
Organisation | Liverpool School of Tropical Medicine |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | We are collaborating on an EDCTP grant together which follows on from the BabyGel MRC Pilot Study. |
Collaborator Contribution | We are all part of the trial management group, and lead various workpackages on the study. |
Impact | There have been multiple outputs from this group which arose from the MRC funded BabyGel pilot study. The full study is now commencing and will produce further outputs in due course. |
Start Year | 2012 |
Description | Babygel Research Group |
Organisation | Makerere University College of Health Sciences |
Country | Uganda |
Sector | Academic/University |
PI Contribution | We are collaborating on an EDCTP grant together which follows on from the BabyGel MRC Pilot Study. |
Collaborator Contribution | We are all part of the trial management group, and lead various workpackages on the study. |
Impact | There have been multiple outputs from this group which arose from the MRC funded BabyGel pilot study. The full study is now commencing and will produce further outputs in due course. |
Start Year | 2012 |
Description | Babygel Research Group |
Organisation | Mbale Regional Hospital |
Country | Uganda |
Sector | Hospitals |
PI Contribution | We are collaborating on an EDCTP grant together which follows on from the BabyGel MRC Pilot Study. |
Collaborator Contribution | We are all part of the trial management group, and lead various workpackages on the study. |
Impact | There have been multiple outputs from this group which arose from the MRC funded BabyGel pilot study. The full study is now commencing and will produce further outputs in due course. |
Start Year | 2012 |
Description | Babygel Research Group |
Organisation | Ministry of Health, Uganda |
Country | Uganda |
Sector | Public |
PI Contribution | We are collaborating on an EDCTP grant together which follows on from the BabyGel MRC Pilot Study. |
Collaborator Contribution | We are all part of the trial management group, and lead various workpackages on the study. |
Impact | There have been multiple outputs from this group which arose from the MRC funded BabyGel pilot study. The full study is now commencing and will produce further outputs in due course. |
Start Year | 2012 |
Description | Babygel Research Group |
Organisation | Sanyu Africa Research Institute |
Country | Uganda |
Sector | Hospitals |
PI Contribution | We are collaborating on an EDCTP grant together which follows on from the BabyGel MRC Pilot Study. |
Collaborator Contribution | We are all part of the trial management group, and lead various workpackages on the study. |
Impact | There have been multiple outputs from this group which arose from the MRC funded BabyGel pilot study. The full study is now commencing and will produce further outputs in due course. |
Start Year | 2012 |
Description | Babygel Research Group |
Organisation | University of Bergen |
Country | Norway |
Sector | Academic/University |
PI Contribution | We are collaborating on an EDCTP grant together which follows on from the BabyGel MRC Pilot Study. |
Collaborator Contribution | We are all part of the trial management group, and lead various workpackages on the study. |
Impact | There have been multiple outputs from this group which arose from the MRC funded BabyGel pilot study. The full study is now commencing and will produce further outputs in due course. |
Start Year | 2012 |
Description | WHO Collaborating Centre for Research and Research Synthesis in Reproductive Health |
Organisation | World Health Organization (WHO) |
Department | Department of Reproductive Health and Research |
Country | Global |
Sector | Academic/University |
PI Contribution | The Terms of Reference are: 1. Collaborate in research synthesis to support the translation of evidence-based research findings into WHO policy and services in the area of maternal and newborn health |
Collaborator Contribution | To advise on research proposals and protocols, contribute to Trial Steering Groups |
Impact | The WHO officers contribute to all the research proposals within the Sanyu Research Unit by commenting on the protocols. In addition, Julie Storr was a co-investigator on the BabyGel Study and Metin Gulmezoglu chaired the Steering Committee for INFORM study. |
Start Year | 2012 |
Title | The BabySaver Tray: a bedside resuscitation unit for low resource settings |
Description | The BabySaver Tray is a low cost version of the LifeStart Trolley which was successfully developed for the bedside resuscitation of newborn babies. Whilst the LifeStart Trolley costs many thousands of pounds, we sought to create a version that costs under $20. This was done in collaboration with Peter Watt of the Department of Clinical Engineering. Initial cardboard structures were shown to colleagues in Uganda for comment and refined. A final version was vacuum formed by the clinical engineering team at Bryn y Neuadd Hospital, Wales. The decision was made to transfer to IP to the Sanyu Africa Research Institute in Mbale, Uganda for development. Together we submitted an funding application to Grand Challenges Canada and were awarded CAD 100,000 to develop the unit. |
Type | Support Tool - For Medical Intervention |
Current Stage Of Development | Early clinical assessment |
Year Development Stage Completed | 2018 |
Development Status | Under active development/distribution |
Impact | No impacts as yet as it is still in the development phase. |
Description | A pilot cluster randomised trial of alcohol-based hand rub to prevent community neonatal sepsis in rural Uganda (poster presentation at the Global Women's Health Society conference) |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Prof Weeks presented this poster about the BabyGel research. He made himself available to take questions around both his poster and the wider question of consent procedures in low resource settings. The conference is a UK-based Global Maternal Health conference run every 18 months to bring together UK and international researchers exploring maternal health in low resource settings. |
Year(s) Of Engagement Activity | 2016 |
Description | Annual meeting of European WHO Collaborating Centres in Edinburgh |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Annual meeting of European WHO Collaborating Centres at which we each present our ongoing work. |
Year(s) Of Engagement Activity | 2018 |
Description | BabyGel AGM, Nairobi. |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Two day meeting in Nairobi to review the progress of the BabyGel study. |
Year(s) Of Engagement Activity | 2022 |
Description | BabyGel Annual General Meeting, Paris, France |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Hybrid meeting in Mbale, Uganda and Paris, France to review the progress of the BabyGel study. |
Year(s) Of Engagement Activity | 2023 |
Description | BabyGel Core Team SIV Training |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Presentation delivered for the BabyGel Core Team SIV Training. |
Year(s) Of Engagement Activity | 2020 |
Description | BabySaver Tray launch |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | We launched the BabySaver Tray at the Uganda Association of Obstetrics and Gynaecologists annual meeting in Kampala (23 Aug 2018), and at a press conference in Liverpool (12th Sept 2018). I gave a talk about it, and we had a stall to demonstrate its use. There was a lot of media coverage with newspaper articles in the Ugandan national press, Ugandan TV, UK BBC regional news coverage (TV and radio) and local Liverpool newspaper coverage. |
Year(s) Of Engagement Activity | 2018 |
URL | https://www.thebabysaver.org/ |
Description | BabySaver Tray poster at ICHG conference |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | I had a poster and demonstration at the RCP International Child Health Group winter meeting at Alder Hey hospital in Liverpool. |
Year(s) Of Engagement Activity | 2018 |
Description | Babygel development group launch meeting in Mbale, Uganda |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Launch meeting of Babygel group to run large cluster randomised trial in Eastern Uganda. |
Year(s) Of Engagement Activity | 2018 |
Description | CONSHA meeting |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | CONSHA is a $8m NIH funded study to examine neonatal hydrocephalus in Uganda run by Prof Steven Schiff of Penn State University. One of my PhD students is funded by this programme. |
Year(s) Of Engagement Activity | 2018 |
Description | Conducting research in low income settings talk |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Undergraduate students |
Results and Impact | Conducting research in low income settings talk for The British Undergraduate Society of Obstetrics and Gynaecology. |
Year(s) Of Engagement Activity | 2021 |
Description | Conference e-poster at RCOG World Congress in Birmingham,, UK Workstream 3 "Optimizing informed consent for participants in randomised controlled trials: a comparison of three different methods"; |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | The Babygel study is looking at the use of alcohol based hand-rub as a possible means of reducing infant morbidity and mortality due to neo-natal sepsis in a cohort of babies in Mbale, Eastern Uganda. Three posters in total from this study are being presented at RCOG World Congress in 2016. The third poster represented part of the Babygel pilot study which looked at "Optimizing informed consent for participants in randomised controlled trials: a comparison of three different methods"; an area of investigation looking at different methods of consent. The women were offered patient information sheets in paper-based format, offered them as Power-Point presentations and the third option was in video format. The women were visited 48 hours after each presentation was given and interviewed about their level of understanding from what they had seen. Our results showed that the slide show consent model is the preferred model for recruitment of pregnant women into randomised controlled trials in rural Ugandan settings. Though the study was conducted on a small sample, the slide show was found to enhance communication between researchers and the potential participants. The RCOG Congress is one of the most prestigious conference for professionals engaged in both maternal health clinical work and research. This study is using a new technology which attempts to address the issue of neo-natal sepsis. Presenting information about this study at this conference will |
Year(s) Of Engagement Activity | 2016 |
Description | EDCTP Forum, Paris, 2023 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Annual meeting for those funded by EDCTP. |
Year(s) Of Engagement Activity | 2023 |
Description | GLOW 2020 Conference organisation |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Prof Andrew Weeks chaired the GLOW 2020 organising committee and also took part at the conference as a moderator and presenter (decolonising global health, running an online conference). |
Year(s) Of Engagement Activity | 2020 |
Description | GLOW Conference 2022, Birmingham. |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | I attended the GLOW 2022 conference, which I had helped arrange. I gave a presentation on instrumental birth in low and middle income countries. One of my PhD students gave a presentation on the fetal monitoring study (part of MOLI study). |
Year(s) Of Engagement Activity | 2022 |
Description | GLOW conference debate chair |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | I am on the steering committee for the GLOW Society (Global Women's Health) that has a conference every 1-2 years. In this year conference in Cambridge I chaired a round-table discussion with female African scientists about the role of women in science. |
Year(s) Of Engagement Activity | 2018 |
Description | Global Fund Academic Advisory Group (GFAAG) meeting |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Member of the steering committee for this global health research programme. |
Year(s) Of Engagement Activity | 2021 |
Description | Global Health CSG |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | I sit on the RCOG Global Maternal Health Clinical Study Group. This meets 3 times per year to co-ordinate global maternal health activity. |
Year(s) Of Engagement Activity | 2018 |
Description | Innovations in maternity care: achieving success against the odds |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | This was an invited lecture to the British Journal of Midwifery Annual conference. |
Year(s) Of Engagement Activity | 2018 |
Description | James Lind Alliance Priority Setting Partnership in rural Uganda- maternal health |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | Collaboration with JLA to run a Priority Setting Partnership in rural Uganda. Ongoing project to be completed in 2020. |
Year(s) Of Engagement Activity | 2019 |
Description | James Lind Alliance Steering Committee |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | I attended a committee meeting composed of local stakeholders and members of the public to develop and refine a JLA priority setting exercise. |
Year(s) Of Engagement Activity | 2024 |
Description | Keynote lecture at a national midwifery conference on research in low income settings |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Keynote lecture on 'The highs and lows of conducting research in low resource settings' at the 13th National Conference on Current Issues in Midwifery: The changing landscape of maternity care. 23rd and 24th March 2015 at the Cavendish Conference Centre, London |
Year(s) Of Engagement Activity | 2016 |
Description | Lecture on Global Women's Health for medical students |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Undergraduate students |
Results and Impact | Lecture for Year 3 medical students on global women's health. |
Year(s) Of Engagement Activity | 2020 |
Description | Meeting with Permanent Secretary of Ministry of Health, Uganda |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | Formal consultancy - Permanent Secretary of Ministry of Health consulted Professor Andrew Weeks to discuss long-term collaboration between Uganda and Liverpool. |
Year(s) Of Engagement Activity | 2019 |
Description | Meeting with the Vice Chancellor of Busitema University, Uganda |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Schools |
Results and Impact | Meeting with the Vice Chancellor of Busitema University, Uganda, to discuss ongoing collaboration and support for Busitema University. |
Year(s) Of Engagement Activity | 2019 |
Description | NIHR GCRF Stillbirth Advisory Board |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | I am a member of the advisory group for the University of Manchester Stillbirth project (funded by NIHR Grand Challenges Research Fund). The project seeks to explore the causes of stillbirth in African countries. |
Year(s) Of Engagement Activity | 2018 |
Description | NVOG Gynaecongres, Amsterdam: 'Working in the global health arena: challenges and opportunities' |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Professor Andrew Weeks gave a keynote lecture 'Working in the global health arena: challenges and opportunities' at the NVOG Gynaecongres in Amsterdam, Netherlands, to launch their global health programme. |
Year(s) Of Engagement Activity | 2019 |
Description | Optimizing informed consent for participants in randomised controlled trials: a comparison of three different methods (poster presentation at the Global Women's Health Society conference) |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Prof Weeks presented this poster about the BabyGel research methods research. He made himself available to take questions around both his poster and the wider question of consent procedures in low resource settings. The conference is a UK-based Global Maternal Health conference run every 18 months to bring together UK and international researchers exploring maternal health in low resource settings. |
Year(s) Of Engagement Activity | 2016 |
Description | Outreach - teaching of midwifery students at LJMU |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Undergraduate students |
Results and Impact | Lecture on global health for LJMU midwifery students. |
Year(s) Of Engagement Activity | 2020 |
Description | Preventing neonatal sepsis in rural Uganda: a cross-over study comparing the tolerance and acceptability of 3 alcohol-based hand rub formulations (poster presentation at the Global Women's Health Society conference) |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Prof Weeks presented this poster about the BabyGel handrub acceptability research. He made himself available to take questions around both his poster and the wider question of consent procedures in low resource settings. The conference is a UK-based Global Maternal Health conference run every 18 months to bring together UK and international researchers exploring maternal health in low resource settings. |
Year(s) Of Engagement Activity | 2016 |
Description | Public Health Priorities in low resource settings |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Undergraduate students |
Results and Impact | This was a lecture to medical students at Busitema University Medical School. |
Year(s) Of Engagement Activity | 2017 |
Description | RCP ICH Group 'The appropriate technology to achieve UHC' |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Professor Andrew Weeks gave a lecture on the use of appropriate technology to achieve universal health care to the Royal College of Physicians, International Child Health Group. |
Year(s) Of Engagement Activity | 2019 |
Description | Royal College of Obstetricians and Gynaecologists (RCOG ) Conference e-poster - World Congress - Birmingham UK, June 2016 Babygel Study: Workstream 2 - acceptability of alcohol based hand rub study |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | The Babygel study is looking at the use of alcohol based hand-rub as a possible means of reducing infant morbidity and mortality in a cohort of babies in Mbale, Eastern Uganda. Three posters in total from this study were presented at RCOG World Congress in 2016. The second poster covered activity which took place prior to commencement of the main pilot study in the second work-stream. This workstream was important as it primarily involved mothers in Mbale informing the investigative team of their preferences. The women in Mbale were asked to select the optimal hand rub for use in an open, 2-arm cluster randomised controlled trial (RCT) comparing alcohol hand rub with normal hand hygiene care. This pilot is one of 3 studies being conducted in preparation for the main BabyGel cluster RCT, and will take place in villages around Mbale, Uganda. This workstream will assess whether the addition of bitterants and perfume affects the acceptability of the handgel. This will be done through a randomised cross-over study amongst mothers in the community using 3 handgel formulations: plain alcohol (no bitterant or perfume added), alcohol with added bitterant and alcohol with added perfume. The women were asked to use each of the three optional handgels for one week at a time (with a wash out period in between weeks). After completion of testing the third hand gel the women were then asked to report on which formulation they preferred and the one which most women chose was used in the main pilot study. The RCOG Congress is one of the most prestigious conference for professionals engaged in both maternal health clinical work and research. This study is using a new technology which attempts to address the issue of neo-natal sepsis. Presenting information about this study at this conference will reach a large audience of fellow maternal health researchers enabling strategic dissemination about this study. |
Year(s) Of Engagement Activity | 2016 |
Description | Royal College of Obstetricians and Gynaecologists (RCOG) - Annual Conference(June 2016) - Birmingham, UK - Poster Presentation - Babygel study "Preventing neonatal sepsis in rural Uganda: a cross-over study comparing The tolerance and acceptability of 3 alcohol-based hand rub formulations" |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | EP6.048 (Conference e-poster booklet reference) Study title: A pilot cluster randomised trial of alcohol-based hand rub to prevent community neonatal sepsis in rural Uganda Preventing neonatal sepsis in rural Uganda: Poster title: A cross-over study comparing The tolerance and acceptability of 3 alcohol-based hand rub formulations Ditai, J(1),(2); Abeso, J(3); Mudoola, M(1); Faragher, B(4) Adengo, M (1); Richards, JD(4); Carrol, E (5); Olupot-Olupot P (3); Storr, J (6); Gladstone, M(2); Medina-Lara, A(7) (1) Sanyu Africa Research Insitute, Mbale, Uganda; (2) Sanyu Research Unit, University of Liverpool, Liverpool, UK; (3) Mbale Regional Referral Hospital, Mbale, Uganda; (4) Liverpool School of Tropical Medicine, Liverpool, UK; (5) Institute of Infection and Global Health, University of Liverpool, Liverpool, UK; (6) WHO, Geneva, Switzerland; (7) University of Exeter, Exeter, UK Introduction Neonatal sepsis is a global problem causing 0.5 million deaths annually, most of which are in low-resource settings. Babies born in African rural homes without running water or toilet facilities are especially vulnerable. Alcohol-based hand rub (ABHR) is widely used to prevent infection. However, it is not known whether supplying it for regular perinatal use can prevent newborn deaths in settings with limited access to running water. Methods A cluster trial was piloted in 10 villages in Mbale district, Eastern Uganda. Five villages were selected as intervention clusters and five as controls. Pregnant women of over 34 weeks of gestation were recruited over a 3-month period and followed-up for 3 months postnatally. Data were collected electronically on mobile phones using Open Data Kit (ODK). Women in intervention villages received a clean birthing kit (Maama Kit) along with a supply of ABHR whilst those in the control villages received the Maama kit only. Those with the ABHR were asked to use it at birth, as a single whole-body neonatal wash, on the cord stump and for 3 months postnatal hand hygiene. Women with concerns about their babies took them to either local health centres or Mbale Regional Referral Hospital. Upon arrival, the infants were screened for sepsis using the WHO/Young Infant Clinical Signs Study Group criteria; a positive response was the study's primary outcome. Secondary outcomes were quantitative and qualitative, and included infant sepsis (physiciandefined and microbiological), infant mortality, quality of life (WHOQOL-BREF), and acceptability of study and intervention. Recruitment rates and inter-cluster coefficient were also assessed. Results 175 pregnant women screened in the 10 villages from October to December 2015, 103 women were over 34 weeks and all agreed to participate. One woman in the intervention arm later withdrew her consent. 93 of these have already given birth and of these, 37 infants have completed follow-up. Five infants died (14%) and 15 others self-referred with suspected infection (41%). Follow up of all participants will be finished by April 2016 and full results will be presented at the conference. Conclusion The trial processes for the cluster randomised trial of community distribution of ABHR to prevent infant sepsis worked efficiently and recruitment rates were excellent. The ODK online data collection functioned well and there was no loss to followup. Final analysis of follow-up data is awaited to fully assess feasibility |
Year(s) Of Engagement Activity | 2016 |
Description | Talk at the International Maternity Experience Conference 2020 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Presentation on "The effects of lockdown globally on perinatal health" at the IME conference 2020. |
Year(s) Of Engagement Activity | 2020 |
Description | Teaching LSTM Diploma in sexual and reproductive health (DSRH) students |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Postgraduate students |
Results and Impact | Discussion with LSTM DSRH students. |
Year(s) Of Engagement Activity | 2020 |
Description | Uganda UK Health Alliance Maternal and Child Health Consortium meeting |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Specialty interest group on health care links between Uganda and the UK. |
Year(s) Of Engagement Activity | 2021 |
Description | WHO Guideline Development Group to update recommendations on care of preterm or LBW infant. |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Work on WHO Guideline Development Group to update recommendations on care of preterm or LBW infant. |
Year(s) Of Engagement Activity | 2021 |
Description | WHO scoping meeting for guidelines for care of the preterm and small for gestational age infant |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | WHO meeting to work on guidelines to improve the quality and outcome of very preterm birth. |
Year(s) Of Engagement Activity | 2020 |
Description | Women in Trouble conference |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Undergraduate students |
Results and Impact | I gave a 30 minute lecture on 'Health care for women in time of war: a personal story'. Feedback was that it was the highlight of the conference for many attendees. |
Year(s) Of Engagement Activity | 2018 |
Description | Women's Voices in African Low Income Settings |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | This was a working group set up to take forward the concept of PPI (Patient and public involvement) in research in low income settings. Interested parties came from Leicester, London, Liverpool and Uganda to develop a funding application. |
Year(s) Of Engagement Activity | 2018 |